Depression, low self-worth, disorientation, marginalization, unresolved problems or disputes, paranoia, grief, jealousy, interaction problems, memory loss, speech topics and passing time are some of the problems facing elderly clients in home and elderly care today. The same problems are faced by clients hospitalized as well as those associated with health care in other ways. (Uudistuva mielenterveys työ, Maria Vuorilehto, Tuulevi Larri, Marjo Kurki ja Heli Hätönen, Vanhusten perheterapia, Hilkka Virtanen) My own experiences from elderly care especially communication with the help of different content, extensive field trips and research in a health care and hospital environments have contributed to this invention. Also discussions with elderly care institutions and with other comparables about existing products and need accompanied by the many budgetary constraints of today has formed this product.
Going through the clients or patients life cycle is very beneficial in therapy for the elderly. When going through the life cycle family members can relate the client's current problems to problems in the past. The family members can be activated to use similar methods in the present situation to those found beneficial in the past. Elderly people can better realize the value and meaning of their life. The life cycle also presents a constructive way of going through unresolved prior problems. The following situations in particular are useful to be treated with a life cycle approach: Depression of an elderly where the life cycle is used to outline her life's meaning and value also in relation to the family. Grief related to somatic illness of a partner. In dealing with the common grief and in preparation for the future. A paranoia that has started at an older age. In communication and interaction problems between the patient or client and her adult children. The life cycle view constructively helps with the fundamental problems at the root of the interaction problems. The same methods are used in family therapy for the elderly as in family therapy overall, cultural differences considered of course.
All family therapy techniques are applicable to elderly care as well. Therefore it is very beneficial that many techniques can be applied. Especially a family oriented approach can be useful. This can be helpful for younger members later when reflecting on things. The focus is thus adapting to the situation, supporting family members or changes in the inner dynamics of the family. The goals can be divided into 5 categories: Treating current interaction problems in the family or bettering interaction. Helping the family deal with the difficult situation. Dementia does not hinder the treatment. Helping the elderly view their life as meaningful, valuable and important. In executing preventive psychiatric work for the family members. This can pertain to a family living in the same household but also in families far apart, between siblings and where the elderly is institutionalized. The therapy can consist of simple interaction or a situation where the family is encouraged to actively take part in the different phases of the treatment.
Music therapy has advanced especially in the US during the past 15 years. In music therapy both the music and the therapeutic relationship to the patient are essential. (Dileo-Maranto 1991, 1992, 1993) I.e. it is important to have a good relationship and know the patient well also music vise. Medical goals of music therapy can be summarized in the following way: Relieving stress and agitation, relieving pain, relieving depression, helplessness, and bettering the immune function. Pain relief and diverting the patient's attention elsewhere can aid the healing process. The reduction of typical emotions that are linked to sickness like depression, helplessness, isolation, withdrawal, losing control and so on can be physiologically beneficial to the patient. Through research it has also been found that one by listening to music has been able to improve a part of the immune function. (Maranto 1993) Some common points in relation to music therapy and other therapy from the literature. Firstly it seems that music has the ability to affect individuals' bio medically and psycho-socially at the same time. Thus it seems as music is a particularly effective and immediate form of treatment for medical illnesses. Secondly, music unlike other medical interventions does not hurt or inflict pain on the patient. Thirdly, contraindications for using music are small and side effects at most small. Fourth, music is easy to use for the patient both as a treatment and in home care. It allows the patient to slightly take control of her treatment and be part of it. And lastly the cost effect relationship is good in relation to sky high costs of other medical intervention. (Maranto 1992, 1993) Below are uses for music from the research literature: Music awakens physiological reactions and is a complex stimulus. Music provokes psychological reactions. Music evokes images and associations and can drive a little bit the same thing as images and pictures. They can work together especially as the patient or client is well known. Music raises cognitive reactions. These reactions may be important for the effectiveness of therapeutic intervention. Music can cause physiological and/or psychological resonance. This is stated as a physics process in research. Physiological, psychological and cognitive reactions to music are individual. It is thus important to know the patient or client.
The musical uses in medicine are many I will list the sectors here to give an overview: Music in surgery: Is good for lowering stress, restlessness, blood pressure, speeds up healing etc. Music in the Neonatal Intensive Care Department: positive and calming effects. Music in pediatric care: reduces anxiety and stress. Music in physical rehabilitation: Is good for rhythmic movements, improves motoric ability, reduces tension and motivates. Music in treating respiratory disease: resonates breathing, improves breathing and relieves restlessness. Music in treating burns: alleviates pain, reduces heart beat during procedure and reduces psychological trauma etc. Music in pain relief: impacts psychological and physiological aspects, increases calm, increases the pain threshold and reduces the need for pain medication. Music in stress relief: reduces muscle tension, psychological anxiety, blood pressure and is calming overall. Music in general hospital or intensive care: reduces anxiety, alleviates pain, increases the feeling of wellbeing, calming, entertaining and betters the mood. Music during labor: reduces fear and anxiety, controls breathing, shortens the process and is positive and soothing for everyone involved. Music in oncology and terminal care: alleviates pain, presents opportunity to draw attention away from disease, alleviates talking about the disease, reduces restlessness, offers some control/reduces helplessness, helps the patient deal with sickness and death and helps the family with things regarding the patient.
Combining music with therapy and with pictures and movies is very appropriate. Aristoteles of Greece wrote about the cleansing properties of music and art. In Finland the University of Helsinki found that music listeners rehabilitated faster, music was found to calm patients and familiar music was found to alleviate psychological stress and to raise patients' mood. Music worked well with normal choirs' as well raising thoughts, images and stimulating the brain. Less depression and disorientation was found among patients receiving music rehabilitation. This was also studied in relation to elderly care. As was found in the previous, music has many positive effects. (Musiikkipsykoterapia Teoria ja käytäntö Oulun yliopisto 2014. Sami Alanne)
Picture and movie therapy is based on basically 4 factors: Identification, the need to relate to the characters, the environment and form a sufficient emotional connection. Projection, the need to reflect on the characters or through them, different usually powerful emotions. Imitation, the need to replicate and mimic characters appearance for learning and values in one's own life. Idealization, the need to get or create ideals, authority figures and role models. Movies are very suitable to therapeutic work to which especially home movies are counted. This can work over a longer or shorter period of time and is good in forming patient/client interaction. All kinds of personalities can watch recordings alone or together for personal fulfillment and approval. This is also good for group dynamics. Self-searching and documentation is also an effective form of movie therapy. A recording can even be added to the medical history. In picture, art, music, dance, literature and drama therapy movies can work as an effective addition or documenter. Using movies as a form of therapy requires a good knowledge of the client. With a movie one can create many associations to the client, her feelings, and handled topics within a group and its member's events and turns of life drawing the client closer. With pictures, movies and sound art can be created. A bridge can be formed between the therapist and the client. (Elokuvaterapiasta eli elävän kuvan hoidollisesta käytöstä, kirjan perustiedot 1996. Pekka Mäkipää)
Do professional psychologists use motion pictures in clinical practice? If so, do they consider motion pictures to have therapeutic value? Of 827 licensed practicing psychologists, 67% reported the use of motion pictures to promote therapy gains. Most of these practitioners (88%) considered the use of motion pictures as effective in promoting treatment outcome, and only a minority (1%) reported them as potentially harmful. Compared with their psychodynamic counterparts, therapists practicing within eclectic-integrative, cognitive-behavioral, or humanistic frameworks were more likely to view or use motion pictures as therapeutic tools. Psychologists provided individual evaluations of 27 motion pictures that deal with a variety of mental health subjects, and overall they were characterized as “moderately helpful.” (Psychologists' Use of Motion Pictures in Clinical Practice Georgios K. Lampropoulos Ball State University Nikolaos Kazantzis Massey University and Waitemata District Health Board Cognitive Therapy Center Frank P. Deane University of Wollongong)
(Increasing Family Involvement in Elderly Care HAN University of Applied Sciences Department of Information Technology, Communication and Media Ruitenberglaan 26, 6826 CC Arnhem, The Netherlands 7.2014.) This paper describes the design and field trial of the Dynamic Collage, a system which aims support extended family members to take part in the care for an elderly person in a light way manner by sending photos to a digital frame in the elderly home. We evaluated the dynamic collage in a field trial of 4-6 weeks with two families, yielding positive results. Photo-sharing was seen as a valuable contribution by the elderly person and all family members, it provided narrative support for visitors of the elderly and it led to an increased awareness of caregiving behavior and increased cohesion in the family. The study shows there is an opportunity to include Awareness Systems and Persuasive Technology within a participation ecology, which could be beneficial for health care
(Art therapy and psycho-geriatric care Karen L. Drucker) The writer concentrates on psycho-geriatric care in general hospitals and other services offered to elderly people. In connection to e.g. depression, phobias, nervousness and mild states of confusion. Doctor I. H. Mian, consulting psycho-geriatric at Southmead hospital district (Mian 1985) has stated that the main principals of the services are: Early right assessment at home, Interdisciplinary teamwork, Cooperation with other forms of service, Support for relatives and other professional helpers, Contacts with voluntary organizations, The training and attitude formation of the general public and the medical staff, Research. Mrs. Drucker has worked as a therapist in 3 day hospitals. She now focuses on treating people suffering from depression and grief gusts. Art therapy has had a positive impact on remembering, life-cycle viewing and defining the current states pros and cons. She usually deals with ordinary themes like weddings, children, family tree and other surfaced events. Art therapy is seen as a useful escape for which there has not been room for before with the demands of everyday life with no room for “creative “or” human growth”. It is important for elderly people to remember and organize events from the past life. People suffering from dementia have a harder time concentrating making for example drawing harder. Making films, taking pictures, recording and writing can also be included in art therapy. Mrs. Drucker uses these methods at day hospital and in outpatient groups. Today's technology provides many new and easier forms of expression. She also emphasizes the importance of preventive care in the treatment of the elderly. This can be treated with preventive therapy.
The most common disorders of the mind among elderly people are depression, anxiety, psychosis and different mood swing disorders. (Winblad 2007) Middle aged people are also faced with loss and the treatments are much the same. In a care relationship dialogue is highlighted with the treating party. (Punkanen 2001) Picture/photo therapy differs from other art therapy forms in that with pictures the client is stopped to face her past. (Mannermaa 2000, 64.) In picture therapy photographs from the client's life, symbolical pics, associative pics and new pics are used. It is also possible to combine picture therapy with other expressive therapy forms. (Halkola etc. 2009, 18) In picture therapy non professional pictures are used. Taking pictures and taken pictures can be used as therapeutic means. Picture therapy methods are often used with literature, art and music therapy. A different photographical therapy method is suitable for social-, health- and education sectors. Especially persons and entities with self-expression difficulties might benefit from the therapeutic use of photos. Visual language is the power of a photograph, it connects to feelings and experiences. Using photos it is natural to talk about and deal with difficult and sensitive issues. (Halkola et al. 2008, 9-10). Picture/Photo therapy works as other psychotherapies. The aim is to help and alleviate the client's psychological distress and symptoms and trigger a shift in mindset on the emotional and behavioral sides. In therapy the images will be discussed and pictures will be taken. A number of different ways are applied how we are in relation to the photography and picture. Individual or family pictures, old or new images, self-imposed or self imposed. In picture/photo therapy it is important that the images are figurative, as things, objects, and people or of different situations. Looking at the pictures, they bring out emotions, thoughts and images. The common denominators in creative therapies are making and expression.
The results of four studies expressed how leisure activities are a significant factor in aging well. Elderly health, functional ability, independence and experiencing quality of life all improved. (Lee etc., 2011.) By interacting with a friend positive effects can be added. It is not good to live alone. Togetherness, support of friends, appreciation are important things in a humane life. Maintaining Relationships improve quality of life. The idea with health care and nursing is to take the things which are right and do good. (Leino-Kilpi & Välimäki, 2009. 367.)
It should be noted that in Finland the elderly are not mentally as well off as often thought. Elderly Psychiatric care works, unfortunately, as a last resort and is not really a preventive mental health measure, as it was previously intended to be. (Saarenheimo 2003. 90 94) It is reasonable to consider the use of the arts and creative expressions as part of nurses working methods because the elderly psychiatric wards patients are mentally very sick. From this perspective and according to some of the ethical guidelines mentioned above as well as psychiatric cares nurses' ability, photo therapy has according to research, been able to deal with also psychologically very painful and hurtful things.
Regrettably it is clear that without early intervention regarding mental health problems among the elderly, many of them end up in psychiatric institutionalization. Early intervention can prevent problems and increase the quality of life and improve social interaction of elderly people. The forming of human relations and their maintenance is an essential part of a good old age and mental health. It lays a foundation and is also a component of good self-esteem, emotional and stress tolerance. In photo therapy, as well as in other art therapies the combining factors are active, unifying and empowering positive effects. According to these studies phototherapy and creative expressions enable reaching out to people and the evidence from using these methods are clearly positive. Using Photo Therapy could be a great way for many mentally symptomatic elderly to induce a good, intact end of life, but the supply is currently unable to meet the demand. Using photographs as a reminiscence tool is possible for anyone care worker. Photo therapy deals with using photography or photos in the therapy situation. Photo Therapy works like other psychotherapies and is intended to alleviate the patient's psychological symptoms, and trigger a shift in thoughts, feelings and behavior. (Halkola 2009, 19-22.) Photos give people the chance to have a normal conversation within which context also painful things can be dealt with.